July 3, Enclosed is a copy of the decision resulting from the hearing held in the above-referenced matter. Sincerely,

Transcription

1 STATE OF WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES OFFICE OF INSPECTOR GENERAL Earl Ray Tomblin BOARD OF REVIEW Karen L. Bowling Governor 2699 Park Avenue, Suite 100 Cabinet Secretary Huntington, WV Frank Honaker 16 Black Betsy Bottom Road Poca, WV July 3, 2014 RE: HONAKER v. WV DHHR ACTION NO.: 14-BOR-2063 Dear Mr. Honaker: Enclosed is a copy of the decision resulting from the hearing held in the above-referenced matter. In arriving at a decision, the State Hearing Officer is governed by the Public Welfare Laws of West Virginia and the rules and regulations established by the Department of Health and Human Resources. These same laws and regulations are used in all cases to assure that all persons are treated alike. You will find attached an explanation of possible actions you may take if you disagree with the decision reached in this matter. Sincerely, Todd Thornton State Hearing Officer Member, State Board of Review Encl: Claimant s Recourse to Hearing Decision Form IG-BR-29 cc: Erika Young, Chairman, State Board of Review Gilda Bodrogi-Podoaba, Department Representative

2 WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES BOARD OF REVIEW FRANK HONAKER, Claimant, v. Action Number: 14-BOR-2063 WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES, Respondent. DECISION OF STATE HEARING OFFICER INTRODUCTION This is the decision of the State Hearing Officer resulting from a fair hearing for Frank Honaker. This hearing was held in accordance with the provisions found in Chapter 700 of the West Virginia Department of Health and Human Resources Common Chapters Manual. This fair hearing was convened on July 1, 2014, on an appeal filed May 9, The matter before the Hearing Officer arises from the April 17, 2014 decision by the Respondent to deny the Claimant s application for the Low-Income Energy Assistance Program (LIEAP), specifically the emergency component of LIEAP. At the hearing, the Respondent appeared by Gilda Bodrogi-Podoaba. The Claimant appeared pro se. All witnesses were sworn and the following documents were admitted into evidence. Department's Exhibits: D-1 Verification checklist, due date March 23, 2014; LIEAP application dated March 18, 2014; Screen print of Vendor details; Quotation from Airgas USA, LLC, dated March 18, 2014 D-2 Verification checklist, due date March 30, 2014; LIEAP application dated March 25, 2014; Client Referral Form for EnAct, Inc., dated March 20, 2014; Client Referral Form for Salvation Army, dated March 18, 2014; Delivery Order from Airgas USA, LLC, dated March 20, 2014 D-3 Screen print of Case comments, entry dates February 11, 2014, through May 9, 2014 D-4 Denial letter, dated April 17, 2014 D-5 Verification checklist, dated March 18, 2014 D-6 Verification checklist, dated March 26, BOR-2063 Page 1

3 After a review of the record, including testimony, exhibits, and stipulations admitted into evidence at the hearing, and after assessing the credibility of all witnesses and weighing the evidence in consideration of the same, the Hearing Officer sets forth the following Findings of Fact. FINDINGS OF FACT 1) Claimant applied for the Low-Income Energy Assistance Program (LIEAP), specifically Emergency LIEAP, on March 18, 2014 (Exhibit D-1), and March 25, 2014 (Exhibit D- 2). 2) Respondent notified Claimant of documentation necessary to determine Emergency LIEAP eligibility in the form of two verification checklists (Exhibits D-5 and D-6). Exhibit D-5 is dated March 18, 2014, and provides a due date of March 23, 2014, for the Claimant to verify proof that you are cooperating in relieving the heating emergency. Exhibit D-6 is dated March 26, 2014, and provides a due date of March 30, 2014, for the Claimant to verify the same information. 3) The information requested by the Respondent was not verified by the Claimant. 4) Respondent issued Claimant a denial notice dated April 17, 2014 (Exhibit D-4), which provides the denial reason as You did not turn in all requested information. The notice specifies this information as Proof that you are cooperating in relieving the heating emergency. 5) Gilda Bodrogi-Podoaba, representative for the Respondent, testified that the Department worker who completed the Claimant s application for Emergency LIEAP made a determination of the amount of Emergency LIEAP benefits potentially available to the Claimant and the amount necessary to relieve the heating emergency. When the amount necessary to relieve the heating emergency exceeds the amount of Emergency LIEAP benefits potentially available to an applicant (as in the Claimant s case), approval of those benefits is contingent upon the applicant securing the remainder from outside agencies or from his or her own resources. 6) Claimant was potentially eligible for $288 in Emergency LIEAP benefits, contingent upon documentation that he had secured the remaining $ necessary to relieve the heating emergency amount of $ This heating emergency amount is based on a quote for the minimum amount of bulk fuel deliverable from the Claimant s supplier (Exhibit D-2, page 6 of 6). Claimant verified pledges from outside agencies as follows: $100 from EnAct, Inc. (Exhibit D-2, page 4 of 6); and $75 from Salvation Army (Exhibit D-2, page 5 of 6). Claimant was responsible to document payment of the remaining $ BOR-2063 Page 2

4 7) Claimant paid the remaining $58.15, but did not document this payment to the Respondent. Claimant testified that he was not verbally advised of this requirement and was unsure if he received the written notifications advising him of this requirement. APPLICABLE POLICY Policy for the LIEAP program (and its emergency component) is located in the West Virginia Income Maintenance Manual (WVIMM), Chapter 26. Specifics regarding the verification requirements in the LIEAP application process are located at 26.3.C. This policy reads, Failure or refusal on the part of the applicant to obtain verification when required or requested will result in a denial of the application. The eligibility requirements for Emergency LIEAP are located at 26.2.B. At 26.2.B.3.c(4), policy reads that when the amount required to eliminate a heating emergency exceeds the amount of the Emergency LIEAP entitlement, the Worker must determine if the applicant is eligible for other program benefits in addition to LIEAP, such as Community Resource Referrals Chapter 4 of the WVIMM addresses verification, and at 4.1 reads, It is an eligibility requirement that the client cooperate in obtaining necessary verifications. The client is expected to provide information to which he has access and to sign authorizations needed to obtain other information. At 26.3.E.3, the WVIMM reads, When the amount required to eliminate the emergency exceeds the amount of the Emergency LIEAP payment, the application for Emergency LIEAP benefits is denied if the emergency is not eliminated. The applicant must find other resources or negotiate with the home heating supplier to accept the Emergency LIEAP benefit. DISCUSSION The Respondent denied the Emergency LIEAP application of the Claimant based on a failure to provide required verifications. The fact that the Claimant was potentially eligible for Emergency LIEAP benefits, the amount of those potential benefits and the amount necessary to eliminate the heating emergency are not in dispute. There was no evidence or testimony that the Claimant negotiated with his bulk fuel supplier to accept the amount of his LIEAP entitlement, so the Claimant was required to find other resources to meet the difference of his emergency and entitlement amounts. The Respondent provided the Claimant referrals to outside community agencies and notified him of his requirement to verify he had met that difference with other resources. The Claimant testified that he was unaware of this verification requirement, but this is unconvincing in light of the fact that he did verify the amount pledged to him through these agencies, just not the amount that he ultimately paid himself. Policy clearly places the burden of providing information to which he has access on the Claimant, and requires the denial of LIEAP benefits for failure to provide required verifications or when the heating emergency is not eliminated. 14-BOR-2063 Page 3

5 CONCLUSIONS OF LAW 1) Because the Claimant s heating emergency amount exceeded his potential LIEAP entitlement amount, approval for the potential LIEAP entitlement amount hinges on acceptance by the Claimant s bulk fuel supplier of the entitlement amount or the acquisition of resources outside of the Respondent to meet the difference between emergency and entitlement amounts. 2) Because there was no indication the Claimant successfully negotiated with his bulk fuel provider to accept the entitlement amount, the difference between the emergency and entitlement amounts must be secured. 3) Because the Claimant s acquisition of resources outside of the Respondent is information to which he has access, it is the responsibility of the Claimant to verify this information. 4) Because the Respondent must deny Emergency LIEAP applications when the emergency is not eliminated, verification that the Claimant secured sufficient outside resources to eliminate his heating emergency is both necessary and required information. 5) Because the Claimant failed to provide necessary and required eligibility information, the Respondent was correct to deny the Claimant s Emergency LIEAP application. DECISION It is the decision of the State Hearing Officer to uphold the Respondent s denial of the Claimant s application for the emergency component of LIEAP benefits. ENTERED this Day of July Todd Thornton State Hearing Officer 14-BOR-2063 Page 4